Background
The genetic risk factors for susceptibility to chronic obstructive
pulmonary disease (COPD) are still largely unknown. Additional genetic
variants are likely to be identified by genome-wide association studies in
larger cohorts or specific subgroups.
Methods
Genome-wide association analysis in COPDGene (non-Hispanic whites and
African-Americans) was combined with existing data from the ECLIPSE,
NETT/NAS, and GenKOLS (Norway) studies. Analyses were performed both using
all moderate-to-severe cases and the subset of severe cases. Top loci not
previously described as genome-wide significant were genotyped in the ICGN
study, and results combined in a joint meta-analysis.
Findings
Analysis of a total of 6,633 moderate-to-severe cases and 5,704
controls confirmed association at three known loci:
CHRNA3/CHRNA5/IREB2, FAM13A, and HHIP
(10−12 < P < 10−14),
and also showed significant evidence of association at a novel locus near
RIN3 (overall P, including ICGN =
5•4×10−9). In the severe COPD analysis
(n=3,497), the effects at two of three previously described loci were
significantly stronger; we also identified two additional loci previously
reported to affect gene expression of MMP12 and
TGFB2 (overall P = 2•6x10−9
and 8•3×10−9). RIN3 and
TGFB2 expression levels were reduced in a set of Lung
Tissue Research Consortium COPD lung tissue samples compared with
controls.
Interpretation
In a genome-wide study of COPD, we confirmed associations at three
known loci and found additional genome-wide significant associations with
moderate-to-severe COPD near RIN3 and with severe COPD near
MMP12 and TGFB2. Genetic variants,
apart from alpha-1 antitrypsin deficiency, increase the risk of COPD. Our
analysis of severe COPD suggests additional genetic variants may be
identified by focusing on this subgroup.
Funding
National Heart, Lung, and Blood Institute; the COPD Foundation
through contributions from AstraZeneca, Boehringer Ingelheim, Novartis, and
Sepracor; GlaxoSmithKline; Centers for Medicare and Medicaid Services;
Agency for Healthcare Research and Quality; US Department of Veterans
Affairs.